12 papers reviewed
Recurrent Pregnancy Loss
2019 · RCT · 1 of 12
A Randomized Trial of Progesterone in Women with Bleeding in Early Pregnancy (PRISM Trial)
Coomarasamy A et al. · New England Journal of Medicine
In 4,153 women with early pregnancy bleeding, overall progesterone did not significantly increase live births (75% vs 72%). BUT in women with 3+ prior miscarriages, live birth was 72% with progesterone vs 57% with placebo (RR 1.28). No harmful effects.
Read the paper ↗2015 · RCT · 2 of 12
The PROMISE trial: progesterone for recurrent miscarriage
Coomarasamy A et al. · New England Journal of Medicine / Tommy's
826 women with unexplained recurrent miscarriage: those receiving progesterone were no less likely to miscarry than placebo. Important null finding for general RPL population without specific indication.
Read the paper ↗2020 · critical review · 3 of 12
Micronized vaginal progesterone to prevent miscarriage: a critical evaluation of randomized evidence
Devall AJ, Coomarasamy A · American Journal of Obstetrics & Gynecology
Critical evaluation combining PRISM and PROMISE data. Supports progesterone specifically for women with prior recurrent miscarriage and current early pregnancy bleeding. Dose-response relationship with history of loss.
Read the paper ↗2026 · guideline · 4 of 12
Recurrent pregnancy loss: a committee opinion (2026)
ASRM Practice Committee · Fertility and Sterility (ASRM)
Updated ASRM committee opinion on RPL workup and management. Discusses benefit of heparin/aspirin for APS-related RPL and recommends comprehensive evaluation.
Read the paper ↗2014 · cohort · 5 of 12
Treatment of recurrent pregnancy loss by levothyroxine in women with high Anti-TPO antibody
Various · Journal of Research in Medical Sciences
Success rate of pregnancy in women with abnormal anti-TPO treated with levothyroxine was 82.85%. Demonstrates importance of thyroid screening in RPL workup.
Read the paper ↗2023 · review · 6 of 12
The role of uterine natural killer cells in recurrent pregnancy loss and possible treatment options
Various · Fertility and Sterility
Association between elevated uterine NK cells and RPL, but definitive causative relationship is missing. Possible treatments include glucocorticoids, intralipids, and IVIG. Major societies do not yet recommend routine immunological testing.
Read the paper ↗2021 · review · 7 of 12
The role of uterine natural killer cells on recurrent miscarriage and recurrent implantation failure: from pathophysiology to treatment
Various · International Journal of Molecular Sciences
Data suggest abnormally elevated uterine NK cell numbers and defective biological activity are associated with RPL and RIF. Individual studies report improved outcomes with prednisolone, intralipid, and etanercept.
Read the paper ↗2020 · systematic review / meta-analysis · 8 of 12
Immunotherapy to improve pregnancy outcome in women with abnormal natural killer cell levels/activity and recurrent miscarriage or implantation failure: a systematic review and meta-analysis
Various · Journal of Reproductive Immunology
Further research required before recommending immunotherapy for abnormal NK cell activity. Evidence base remains uncertain for routine clinical use.
Read the paper ↗2022 · systematic review / meta-analysis · 9 of 12
Intravenous immunoglobulins improve live birth rate among women with underlying immune conditions and recurrent pregnancy loss: a systematic review and meta-analysis
Various · Allergy, Asthma & Clinical Immunology
IVIG treatment associated with two-fold increase in live birth rate in women with immune conditions and RPL. Careful patient selection necessary; high cost and lack of large blinded trials noted.
Read the paper ↗2024 · systematic review / meta-analysis · 10 of 12
Low-molecular-weight heparin in the prevention of unexplained recurrent miscarriage: a systematic review and meta-analysis
Various · Scientific Reports
LMWH for unexplained RPL did not show benefit on miscarriage or live birth rates. Heparin+aspirin may benefit women with 3+ miscarriages, but not after only 2.
Read the paper ↗2020 · meta-analysis · 11 of 12
Meta-analysis of heparin combined with aspirin versus aspirin alone for unexplained recurrent spontaneous abortion
Various · PubMed
Heparin combined with aspirin increased live birth rate vs aspirin alone in unexplained RSA when number of miscarriages was 3 or greater, but not after only 2 miscarriages.
Read the paper ↗2019 · network meta-analysis · 12 of 12
Comparison of therapeutic interventions for recurrent pregnancy loss in association with antiphospholipid syndrome: a systematic review and network meta-analysis
Various · PubMed
For APS-related RPL, LMWH plus aspirin showed benefit over aspirin alone. UFH plus aspirin showed higher live birth rates. Aspirin alone had lower live birth rate compared to combined therapy.
Read the paper ↗A paper's presence documents the evidence reviewed; it does not mean Filia endorses every intervention or conclusion.